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General NPI Number Information
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NPI Number | 1841306016
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Entity Type | Organization
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Legal Business Name | KHANG VAN TRAN M.D., INC.
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Dates
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Enumeration Date | 08/21/2006
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Last Update Date | 02/20/2013
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Provider Practice Location Address
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Address Line | 4616 EL CAJON BLVD SUITE 9
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City | SAN DIEGO
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State | CA
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Zip | 92115-4426
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Country | US
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Telephone | 619-280-4616
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Fax | 619-280-4617
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Provider Business Mailing Address
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Address Line | 4616 EL CAJON BLVD SUITE 9
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City | SAN DIEGO
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State | CA
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Zip | 92115-4426
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Country | US
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Telephone | 619-280-4616
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Fax | 619-280-4617
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. KHANG VAN TRAN
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Credential | M.D.
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Telephone | 619-280-4616
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State |
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